Archive | Radiation RSS feed for this section

An Uneventful Event

Radiation Treatment #1 (complete with red laser)

I had radiation treatment #1 today, with 35 more in queue each weekday afternoon through Nov 8. No side effects expected for the nonce.

It was easy and uneventful — well, uneventful to my eye. We’ll hope some little prostate cancer cells met an invisible and violent death, but that was nothing for me to see or even feel. The treatment itself involved radiation doses from nine different directions into a band around my pelvis. Ground zero was the prostate fossa, the area where my prostate resided until surgery.

“Lay still and breathe normally,” they told me as I lay on a hard table. The radiation machine circled my pelvis, and the therapists occasionally tweaked the positioning. Some kind of red laser beamed at me from the ceiling next to a sign that warned, Do Not Look at the Laser. All cut and dried, chop-chop. Except.

Except for the frisson, the palpable sensation I’d not had since surgery four years ago. You know how something can happen, and it just drives home and makes vivid the reality of a situation? Surgery drove home, italicized and put in bold my stark reality of 2007: I’ve got cancer, and that’s not good.

Same thing today at Radiation Oncology at the Seattle Cancer Care Alliance. I can’t remember whether today’s realization came while waiting for my first treatment or while talking to the guy waiting for his last; whether I was arranging the schedule for future treatments or was looking helplessly at the radiation machinery arrayed around me. But that old, familiar reality came back and drove itself home:

I’ve still got cancer, and that’s not good.

Surgery + 4 (and More)

Cumberland Gap, TN, KY & VA

Cumberland Gap, TN, VA & KY

It was four years ago today that I had surgery for prostate cancer, and in nine days I’ll begin “salvage” radiation for prostate cancer. Surgery, hormone therapy, now radiation. This strikes me as a lot of treatment in a relatively short period of time — and I spent more than half of the past four years on hormone therapy! All courtesy of the two tiny tumors they found in my lymph nodes after surgery.

The much-awaited phone call came Friday with the date and time to begin rad treatment at the Seattle Cancer Care Alliance. I’m thrilled to get this on the calendar at last, and I’ll be even happier to get the actual treatment underway (remind me of this when the side effects kick in).

Yes, it’s my fault we’ve put radiation off for so many months. Too many travels planned too many months ago, but all the doctors were comfortable with the delay. I’m cutting it close, though: We’ll get back to Seattle on a Monday afternoon, and I’ll report for radiation duty at 9:00 the next morning (Sep 20).

My cancer is microscopic for now and shows up on no scans. So I just have to hope that it resides precisely where the radiation will hit, but there’s no guarantee of that.

As we say all too often in the cancer journey: It is what it is.

Cancer Park

Sri Lanka Aug 2011

Sri Lanka, Aug 2011 (Photo by Rebecca Curry)

Truth be told, my prostate cancer journey has thus far been a relative walk in the park compared to the medically invasive and dramatic, life-altering experiences of others. In the time since my diagnosis, the most disruptive event has been surgery, my radical prostatectomy, and that was only two nights in the hospital, plus recovery.

Contrast that with my friend Toby, who was diagnosed in March with Mantle Cell lymphoma and whose life was abruptly up-ended. He’ll undergo his sixth (and final) R-CHOP 21 chemo treatment today — and that’s just a prelude to his stem cell transplant later this month.

So while they’ve been busy poisoning Toby this summer, I’ve been off traveling in Peru and Sri Lanka, living life much as it was before my diagnosis. (Heck, I was traveling when I received my diagnosis!) Oh, Peru and Sri Lanka brought some unintended weight loss and hot flashes from hormone-therapy, but, as I say, a relative walk in Cancer Park.

That’s about to change with my impending “salvage” radiation. My radiation oncologist is now working on the specific treatment plan — the nitty-gritty to maximize the radiation dosage to offending tissue and minimize collateral damage to the healthy. Sometime in the coming days, a phone call will come with my start date for treatment: then five days a week for seven weeks.

I’m ready — even more than ready. I have my Calypso transponders in place, and on Aug 24, I completed the remaining preliminaries: three tattoos to assist in the targeting of the radiation; a custom-made leg cradle to hold me in place; simulation scans for aiming the radiation, and the official signing of the consent form. All I need now is that telephone call.

Radiation will be my third cancer therapy in four years, not counting the experimental drug I took as part of a clinical trial, and not counting the hormone therapy and the chemo med I’m currently on (both are part of the radiation protocol). But there’ll be no more radiation after this — they just don’t do it twice. There are no do-overs, no mulligans.

It either eliminates the remaining prostate cancer in me, or it doesn’t.

This Week in Cancer

Shaman's Ceremony -- Cusco, Peru. During this offering by fire, I learned via phone that my June 17 oral biopsy was negative. Interesting coincidence.

Monday, July 25, 2011. Lots of cancer doings this week, starting today with a full day at the Seattle Cancer Care Alliance. I’m writing this in the infusion waiting room on the fifth floor, soon to be summoned to resume hormone therapy (officially: androgen deprivation therapy). It’s my second round of ADT; the first time, I had one injection of Lupron every three months for a total of nine injections. This time, I’ll be on it for six months (two shots). Oh, and I’ll also be on Casodex, a chemo pill.

I dread the side effects of ADT — hot flashes, fatigue, mood swings, and general chemo-brain. They worsen with time, the longer I go with no testosterone. But prostate cancer feeds on testosterone, and so ADT is a good systemic treatment. While it works. Eventually, some cancer cells become androgen independent and grow quite nicely without it.

My Lupron injection is to be accompanied by an infusion of Zometa, a bone-strengthener to deal with my osteoporosis (another side effect of ADT). Cancer is so special: We get side effects that, for non-cancerians, are their own dreaded diseases.

It’s been so long that I’d almost forgotten that good news is possible in the cancer experience: My PSA today is sideways. There’s this little mind game men play with their PSA tests: What will it be? How much higher will it go this time? A little? A lot? What’s the number I’d dread to hear? So this PSA test, I played the PSA head game yet again: Q: What’s the best number I can hope for? A: No change.

And that’s what I got! Three months ago, PSA was 0.11; same today. Not sure what to make of it, what it all means, but I sure prefer “stable” over “raging.”

Wednesday, July 27. Today was my maiden voyage to an oncologic naturopath, a huge step for me. I grew up knowing medical care as something that came from a pharmacy, a syringe or a scalpel. But I went to a Survivorship symposium at the Fred Hutchinson Cancer Research Center in June, and they had a break-out session on ‘complementary’ (nee alternative) medicine. I was impressed with the two oncologic naturopaths who presented, and now one of them, Dr. Laura James, is on my side.

This step seemed fully consistent with my diet/nutrition efforts and no different than my looming “salvage” radiation (don’t you just love these terms they come up with?): It’s one more weapon to wield, one additional thing I can do and have some control over. I now have four, naturally occurring compounds in my repertoire of daily therapies, thanks to Dr. James. We’re off to a great start.

Thursday, July 28. Final cancer appt of the week (if you’re trying to keep track, the line score is: 1 infusion; 1 injection; 1 blood draw; 2 doc consults; and, today, 1 implant procedure). I now have three tiny Calypso beacon ‘seeds’ in my pelvis. These gizmos are part of my prep for radiation in the fall. Essentially what they’ll do is keep the radiation zapper on target. If my innards move, or I move, the Calypsos tell the zapper to move accordingly. That keeps the rad beam on target and thus reduces collateral damage to healthy tissue.

Since I leave Sunday for three weeks in Sri Lanka, I’m thinking it’s going to be v-e-r-y interesting dealing with TSA when I march through the airport security scanner with these little Calypsos in me.

It’s a go.

Three doctors, three opinions — and unanimity: I’m going to proceed with radiation, combined with more hormone therapy, in yet another effort to manage my first cancer. I’m not kidding myself that this will “cure” me,  that this will be the silver bullet, that all will be jim-dandy after a go of radiation.

The likelihood is that we’ll only be putting out microscopic brushfires, and that, down the road, some further treatment will be needed. Fair enough. And the docs all agree — and I understand — that there’s no way of knowing for sure that my recalcitrant prostate cancer is in my pelvis and/or abdomen. But there’s a likelihood that at least some of it’s there, and that’s enough for me: To re-quote Lora, let’s kick its ass. (Just writing that makes me feel like I got a kick in.)

I’ve some travels and important life experiences on the calendar, like my 50th high school class reunion, but the docs say, OK. So under current planning, I’ll re-start hormone therapy in late July, be on it for the requisite minimum of two months, and begin radiation the end of  September or soon after. It feels good just to get this stuff on the calendar, like I’ve already pushed back once more.

Most important is doing everything I can. I’ve been aggressive in pushing back at cancer at each stage — an experimental drug before surgery; surgery; hormone therapy after surgery; and diet, exercise and nutrition from the get-go. Ever since my diagnosis, I’ve wielded every weapon extended to me.

And I’m not quitting now.

Hooked on a Feelin’

I’m now on the calendar for three scans in anticipation of radiation to deal with my just-won’t-go-away prostate cancer. Two CT scans, one bone scan. We’re nearing a decision, but — pending new information — the contours in favor of radiation already draw themselves.

My prostate-cancer friend, Tom, wisely observed in an email, “My approach in dealing with my cancer was that there was no room for second-guessing. Whatever feels right is right…and then deal with whatever comes next.”

Whatever feels right.

Indeed. All my attitudes and values about how I deal with my first cancer, how I counter it, and what I do at each step — they all interlace themselves into one, single, solitary feeling: It just doesn’t feel right to walk away from radiation.

Just doesn’t feel right to kick the can down the road and hope for something better after things get worse.

Or as Lora, an ovarian cancer survivor and one of my heroes, told me: “You need to kick ass every chance you get.”

Decisions, decisions…

April 4, 2011, Blood Draw

Spent this afternoon at Seattle Cancer Care Alliance — quarterly blood draw and Radiation 101, my very first consultation on the possibility of rad therapy to my pelvis. There’s a lot to chew on:

There’s good reason to believe the offending cancer is in my pelvis, but no certainty. There’s good reason to believe my cancer is microscopic, given my minuscule level of PSA (0.11). There’s some chance this could be a cure, but a greater chance that it’ll resurface somewhere else later. There’s some chance of long-term side effects Down There, but many of them can be treated.

Bottom line: The rad oncologist says he’d do it. So does my oncologist, knowing me as he does.

I’ve talked with cancer buddies who’ve confronted the radiation option. The decision to go ahead with it (or not) seems to turn on the hinge of values and attitudes, not on the  chance of success or the possibility of nasty side effects. Kristina put it this way: “I told myself that at each stage of my cancer, I’d do whatever I could.” And she wanted to send a message to her cancer: “You give me any trouble, I’ll come after you.”

While percentages and probabilities are derived from really large groups of people, for any one of us — you or me — the results are either 100 per cent or 0 per cent: It works or it doesn’t.

The flip of a coin.

Freakin’ Radiation Conundrum

With the early return of my prostate cancer, my oncologist has raised the option of rad treatment to the pelvis — even though there’s *no certainty* that all of my cancer resides there. That’s thanks to the freakin’ tumors the pathologist found in two lymph nodes snipped out at surgery. I mean, once it’s in your lymph glands, where else has it gone? My armpit? My leg? What I’m grappling with now are unknowable trade-offs: How much good stuff happens? How much risk of nasty side effects? I don’t know squat yet — will see a rad oncologist April 4. Stay tuned.

But should I proceed, radiation would be my third cancer therapy in four years — yikes! — and it would also be the most visible to others and the most disruptive to daily life. It finally became time to talk about my cancer more publicly. Ergo, a blog, My First Cancer.